| NPI | 1578847620 |
|---|---|
| Doing Business As | CLE ELUM DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DANIEL KEITH WHITEMARSH Owner 509-374-7245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WA 60006068) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |